According to Guberman, (1999) the word ‘Home care’ is also known as domiciliary care which refer to health care provided to the patients at home by either health care professional which a times referred to as formal care which in united states they are called skilled care or by family and friends also called caregivers, primary caregiver or voluntary caregivers who give informal care. The term homecare is used to differentiate it from non-medical care or custodial care which is care provided by persons who are not nurses, doctors or other licensed medical personnel.
Direct healthcare providers in homecare
Professional healthcares which include:
- Registered nurses and licensed practical nurses,
- Physical therapist.
Paraprofessionals which include:
- Social workers,
- Speech language pathologist,
- Occupational therapists (OTs),
- Home health aides
Volunteers which include;
- Homemaker and chore workers.
According to Williams et al, (2000) the Services provided by health cares are discussed below;
Physicians visit patients in their homes to diagnose and treat illnesses just as they do in hospitals and private offices. They also work with home care providers to determine which services are needed by patients, which specialists are most suitable to render these services, and how often these services need to be provided. With this information, physicians prescribe and oversee patient plans of care.
Registered nurses and licensed practical nurses
Registered nurses (RNs) and licensed practical nurses (LPNs) provide skilled services that cannot be performed safely and effectively by nonprofessional personnel. Some of these services include injections and intravenous therapy, wound care, education on disease treatment and prevention, and patient assessments. Registered nurses may also provide case management services.
The registered nurses are given specialized education and are licensed to practice once qualified. On the other hand the licensed practical nurses are given specialized training for a given period of time and are licensed to work under the supervision of registered nurses. The intricacy of a patient’s medical condition and required course of treatment determine whether care should be provided by a registered nurse or can be provided by a licensed practical nurse.
Physical therapists work to restore the mobility and strength of patients who are limited or disabled by physical injuries through the use of exercise, massage, and other methods. They often alleviate pain and restore injured muscles with specialized equipment. They also teach patients and caregivers special techniques for walking and transfer.
Social workers evaluate the social and emotional factors affecting ill and disabled individuals and provide counseling. They also help patients and their family members identify available community resources. Social workers often serve as case managers when patients’ conditions are so complex that professionals need to assess medical and supportive needs and coordinate a variety of services.
Speech language pathologists
They work to develop and restore the speech of individuals with communication disorders; usually these disorders are the result of traumas such as surgery or stroke. Speech therapists also help retrain patients in breathing, swallowing, and muscle control.
Occupational therapists (OTs)
They help individuals who have physical, developmental, social, or emotional problems that prevent them from performing the general activities of daily living (ADLs). OTs instruct patients on using specialized rehabilitation techniques and equipment to improve their function in tasks such as eating, bathing, dressing, and basic household routines.
Dietitians provide counseling services to individuals who need professional dietary assessment and guidance to properly manage an illness or disability.
Home health aides
Home health aides assist patients with activities of daily living such as getting in and out of bed, walking, bathing, toileting, and dressing. Some aides have received special training and are qualified to provide more complex services under the supervision of a nursing professional.
Homemaker and chore workers
They perform light household duties such as laundry, meal preparation, general housekeeping, and shopping. Their services are directed at maintaining patient households rather than providing hands-on assistance with personal care.
They provide companionship and comfort to individuals who, for medical and/or safety reasons, may not be left at home alone. Some companions may assist clients with household tasks, but most are limited to providing sitter services.
Generally this group of volunteers meets a variety of patient needs. The scope of a volunteer’s services depends on his or her level of training and experience. Volunteer activities include, but are not limited to providing companionship, emotional support, and counseling and helping with personal care, paperwork, and transportation.
Effects of indirect staffing in homecare
The presence of indirect staff has some positive and negative effects on the patients. Most of these problems are social problems which in turn affect the psychological functioning of the patience. Some of these effects include:
- Increased emotional effects
- Increased social problems
- Decreased food intake.
- Increased unnecessary counseling.
Decreased food intake as a result of emotional effects
“Decreased food intake is an important risk factor for malnutrition, which is highly prevalent among geriatric patients. The emotional nature of the home care experience and the complex organizational setting involved in meal production and delivery services in the home increase the risk for decreased food intake.
Everyday emotions are known to have a particularly strong influence on decision-making and behavior in the patience, and have also been shown to influence food intake and its psychological antecedents, such as quality perception and satisfaction judgments. The direct effect of emotional factor on food is reduced food uptake by the patience while the indirect effects are mediated by the food quality perception on and satisfaction judgment. Quality foods increases appetite hence increased food uptake by the patient”, (Paquet et al, 2003)
Guberman, Nancy, (1999); “Caregivers and Caregiving”: New trends and their implication for policy, British biomedical journal, vol 2.
Paquet, C, St-Armaud_mckenzie, D and Honald Jeff, (2003); “Direct and indirect effects of everyday Emotions on food uptake of elderly patients in institutions”. A Biological Science Journal, vol. 11.
William, A,P.S Wagner, M. Buetther, C. Charlebolis ,K. Foster, B. Gustafson, D. Harf, and E. Jamison, (2000);“Women’s formal home care work in transition”: The impact of reform on labour process change, Biomedical journal,vol.3.